Journal of Musculoskeletal Trauma

Total Hip Arthroplasty Following Acetabular Fracture: Myung Chul Yoo, Yoon Je Cho, Kang Il Kim, Young Soo Chun, Dong Oh Ko, Jin Woong Yi; J Korean Soc Fract 2003;16(2):121-127. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.121

Abstract PDF: PURPOSE
We evaluated the results of secondary total hip arthroplasty (THA) after acetabular fracture. MATERIAL & METHODS: Twenty cases of THA were performed to treat acetabular fracture as a secondary treatment after conservative management (6 cases) or internal fixation (14 cases). The mean follow up period was 5 years 2 months. The cause of secondary THA was post traumatic arthritis in 15 hips and osteonecrosis of the femoral head in 5. Cementless acetabular cup was used in 18 cases and cemented in 2 cases. Cementless femoral component was used in 18 cases and cemented in 2 cases. Serial Harris hip score (HHS), pain, limb length discrepancy and radiographs were evaluated.
RESULTS
HHS improved from 57 points to 91 points. Osteolysis in the acetabular component occurred in 2 cases and 5 cases in the femoral component. Loosening occurred in 2 cases of cemented acetabular components and 1 case in the femoral component. In this study, 3 cases (15%) required revision of the acetabular component and 2 cases (10%) of the femoral component.
CONCLUSION
The clinical results of THA after acetabular fracture was inferior to that of conventional arthroplasty. The secure cementless acetabular fixation with proper bone grafting is mandatory to improve the survival of acetabular component.

93 View
1 Download

Stability and Usefulness of Compression Hip Screw in the Treatment of Femur Intertrochanter Fracture in the Elderly: Jong Oh Kim, Kwon Jae Roh, Yeo Heon Yun, Young Do Koh, Jae Doo Yoo, Jun Mo Jung, Han Cheon Bang, Jae Hak Jung; J Korean Soc Fract 2003;16(2):128-135. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.128

Abstract PDF: PURPOSE
To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fractures of the elderly.
MATERIALS AND METHODS
Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification.
RESULTS
There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10 mm, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10 mm, good results were obtained in 46, and poor in 13 (p<0.001). But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10 mm and 10 cases with less than 10 mm. In comminuted type, there were 11 cases with lag screw sliding more than 10 mm and 2 cases with less than 10 mm (p<0.001).
CONCLUSION
The sliding of lag screw more than 10 mm may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not a good treatment option.

60 View
1 Download

Treatment of Unstable Intertrochanteric Femoral Fracture with the AO/ASIF Proximal Femoral Nail (PFN): Do Hyun Moon, Jang Seok Choi, Geon Beom Kim, Jin Won Kim, Ki Tae Kim; J Korean Soc Fract 2003;16(2):136-142. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.136

PURPOSE
To review the clinical and radiographic results of the treatment of unstable intertrochanteric femoral fractures with a proximal femoral nail (PFN).
MATERIALS AND METHODS
We reviewed 47 unstable intertrochanteric femoral fracture cases that had been treated with a PFN operatively. The clinical and radiographic results and complications were analyzed. The mean age was 76.8 years old (62~96 years old) and the mean duration of follow-up was 15 months (12~24 months).
RESULTS
The postoperative walking ability was regarded as satisfactory when the patient could walk alone using an walking frame without others aids and satisfactory results was achieved in 43 cases (91.5%). In all cases the radiologic bone union was obtained. The average sliding of femoral neck screw was 3.0 mm and the average change of neck-shaft angle was 2.6 degree. There were three cases of postoperative complication which were including 1 case of cut-out of femoral neck screw, local superficial infection in 1 case and pain complaints over trochanteric area in 1 case.
CONCLUSION
The PFN is an useful implant for the treatment of unstable intertrochanteric femoral fracture because of the simplicity of the surgical technique and the low level of the complications encountered.

Citations

Citations to this article as recorded by

Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteic Fractures in the Elderly
Byung-Hak Kim, Young-Yool Chung, Sung-Chang Ki, Dae-Hyun Yoon, Ji-Hoon Ryu
Journal of the Korean Orthopaedic Association.2011; 46(5): 399. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef
Complications of Femoral Pertrochanteric Fractures Treated with Proximal Femoral Nail (PFN)
Kee-Byoung Lee, Byung-Taek Lee
Journal of the Korean Fracture Society.2007; 20(1): 33. CrossRef
Treatment of Intertrochanteric Fracture with Proximal Femoral Nail
Dae Joong Kim, Sung Chan Ki, Young Yool Chung
Journal of the Korean Fracture Society.2007; 20(1): 40. CrossRef

67 View
0 Download
4 Crossref

The Result of Proximal Femoral Nailing (PFN(R)) for Unstable Femoral Peritrochanteric Fracture: Seung Yong Lee, In Heon Park, Kyung Won Song, Sung Il Shin, Jin Young Lee, Jeong Hun Cha; J Korean Soc Fract 2003;16(2):143-147. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.143

Abstract PDF

PURPOSE
We have used the proximal femoral nailing (PFN(R)) to evaluate the result of treatment for unstable femoral peritrochanteric fractures.
MATERIALS AND METHODS
From December 2000 to December 2001, 20 patients who had femoral peritrochanteric fracture were treated with proximal femoral nail (PFN(R)) in our hospital. The mean duration of follow-up was 16.8 months and average age was 58.7 years old. We evaluated the ambulation time, bone union time, neck-shaft angle, neck screw sliding by follow-up radiography, and studied the intra-operative and post-operative complication.
RESULTS
The average ambulation time was 3.8 days, the mean bone union time was 20.9 weeks, the mean neck shaft angle was 130.2 degree at post-operative time and 128.8 degree at last follow-up time, and the average neck screw sliding distance was 4.1 mm. The intra-operative complication was rotation of proximal fracture fragment in 1 case and displacement of femoral greater trochanter in 2 cases at proximal reaming, and displacement of proximal fracture fragment in 1 case at femoral stem insertion. The post-operative complication was coxa vara deformity in 2 cases and superficial wound infection in 1 case.
CONCLUSION
We have conclude that the proximal femoral nail (PFN(R)) could appropriately treat the unstable femoral peritrochanteric fracture and we obtained satisfactory results.

Citations

Citations to this article as recorded by

Treatment of Unstable Pertrochanteric Fractures with a Long Intramedullary Nail
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Dae Jung Huh
Hip & Pelvis.2013; 25(1): 51. CrossRef
Operative Treatment with ITST in Femur Trochanteric Fracture
Ki-Do Hong, Jae-Chun Sim, Sung-Sik Ha, Jae-Young Kim, Jung-Ho Kang, Kwang-Hee Park
Journal of the Korean Fracture Society.2008; 21(4): 274. CrossRef
Comparison Study of Intertrochanteric Fractures Treated with Intertrochanteric/subtrochanteric Fixation with a Standard vs a Mini-incision
Se Dong Kim, Oog Jin Sohn, Jae Ho Cho
Journal of the Korean Fracture Society.2008; 21(1): 1. CrossRef

97 View
0 Download
3 Crossref

The Problems of Plate Fixation in the Management of Periprosthetic Femoral Fracture: Myung Sik Park, Byung Wan Choi, Hyun kyung Bae, Jong Hyuk Park; J Korean Soc Fract 2003;16(2):148-154. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.148

Abstract PDF: PURPOSE
The purpose was to evaluate the postoperative periprosthetic femur fracture of hip arthroplasty and relative problems of management using plate fixation. MATERIAL AND METHOD: We reviewed 37 cases of femoral fractures out of 1,270 (1,183 primary hips and 97 revision hips) hips which received hip arthroplasty during the observation period (1985~1998). We classified them according to the stability and the location of the fractures related to the stem tip: Proximal (I), middle (around stem) (II) and distal (III). Then we subclassified the fractures as cortical perforation or a fissure, undisplaced (A), displaced (B) and unstable prosthesis (C). we managed periprosthetic fracture with splint applied or cerclage proximal fracture (type I), plate fixation and bone grafts in the stem tip (type II) or distal fracture (type III). In unstable fractures, we revised them with long fluted stems.
RESULT
The average union time is 3.1 months (range, 2~6.2 months). After management of fracture with plate showed 5 complications, two nonunion and three refractures. The causes of nonunion are early weight bearing and a too short plate. The causes of refracture are screw fixation and empty hole just distal to stem tip. The other caused by the roles of stress riser in proximal screw of blade plate in management of supracondylar fracture.
CONCLUSION
We recommend the use of cerclage band system or fixed in a more proximal site in long plate and bone graft. In unstable prosthesis, we had taken a best results after revised with distal fluted stem, in which we don't need further distal stability like a additional cerclage or locking screw and additional bone graft.

98 View
0 Download

Treatment of Femoral Shaft Nonunions with Dynamic Compression using Interlocking-Compression (IC) Nail: Youn Soo Park, Young Wan Moon, Ki Sun Sung; J Korean Soc Fract 2003;16(2):155-162. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.155

Abstract PDF: PURPOSE
To evaluate the effectiveness of a specially designed Interlocking-Compression Nail (IC Nail(R), Osteo, Switzerland) which allows compression force across the nonunion site for the treatment of femoral shaft nonunions.
MATERIALS AND METHODS
Between Nov. 1998 and June 2002, twenty one nonunions of femoral shaft fractures in twenty patients were treated with reamed IC nails of larger diameters without bone grafting in 9 men and 11 women, 8 to 45 months after initial operations. Seventeen cases were hypervascular nonunions, 3 avascular, and 1 infected. For initial operation, 10 closed nailing, 10 open nailing and 1 plate fixation were performed. One or more additional procedures had been done in 17 cases prior to IC nailing.
RESULTS
The nonunion gap was considerably narrowed from 7.4 mm to 3.1 mm with IC nailing and bony unions were achieved in all but one case. The time for radiographic union was 4 to 15 months posteoperatively with an average of 7.4.
CONCLUSION
Reamed IC Nail(R) with a larger diameter is an effective procedure for femoral shaft fracture nonunion regardless of initial treatment modalities and even in 3 avascular nonunions, 2 have shown radiographic union without bone grafting. Additional procedures are to be considered in failed surgery of avascular nonunions.

87 View
0 Download

Fatigue Fracture of the Interlocking Nail in the Treatment of Femoral Shaft Fractures: Jung Ryul Kim, Jin Ho Yoon; J Korean Soc Fract 2003;16(2):163-168. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.163

Abstract PDF: PURPOSE
To analyze clinical and mechanical factors of the fatigue fracture of the intramedullary nail in the treatment of the femoral shaft fractures and to consider preventive methods of fatigue fracture.
MATERIALS AND METHODS
We reviewed 12 patients of fatigue fractures of the intramedullary and were followed for a minimum one year. The site of fatigue fracture of the intramedullary nail was at fracture site in 10 cases, just proximal to proximal locking hole in one, and the most proximal of two distal locking holes in one. We analyzed type and diameter of broken nail, time from injury to fatigue fracture, causes of metal failure, and treatment results.
RESULTS
Intramedullary nails which had fatigue fracture were reamed AO nail in four cases, Grosse-Kempf nail in four, Russel-Taylor nail in three, and long Gamma nail in one. Time to fracture of implant was average 13.6 months (range, 6~30 months). All cases were treated by intramedullary nailing, and additional autogenous bone grafting was done in three cases. At an average duration of follow-up of 7.5 months (range, 5 to 10 months), all of the fractures had healed.
CONCLUSION
To prevent fatigue fracture of intramedullary nail, closed obervation for bony union, progressive weight bearing, and augmentation with autogenous bone grafting for comminuted fracture site should be needed.

36 View
0 Download

A Comparative Study of Reamed and Unreamed Nail for Femoral Shaft Fracture's Treatment: Hee gon Park, Myoung ho Kim, Mun jib Yoo, Woo sup Byun; J Korean Soc Fract 2003;16(2):169-176. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.169

Abstract PDF: PURPOSE
The comparative analysis of clinical difference between the use of reamed nail and unreamed nail in treatment of femoral shaft fracture.
MATERIALS AND METHODS
In 105 patients with femoral shaft fracture who were treated with reamed nail or unreamed nail between June of 1997 and April of 2000, 95 patients who underwent more than a year of follow-up were selected. Winquist-Hansen criteria was applied for the classification of fracture. Based on the medical records and radiological examinations, conducted a retrospective, statistical analysis of the duration of operation, the amount of bleeding during operation, the first time of callus formation, union time, and complications.
RESULTS
The average duration of operation was 107 minutes for reamed nail group, and 94 minutes for unreamed nail group, and the difference was statistically significant (p<0.005). The amount of bleeding during the operation was 400 mL for reamed nail group and 250 mL for unreamed nail group, and the difference was statistically significant (p<0.001). There was no statistical difference in the first time of callus formation and union time between the two groups but, in general union time tend to be long in unreamed nail group.
CONCLUSION
In the treatment of femoral shaft fracture, the use of unreamed nail was shown to have an advantage over the use of reamed nail in terms of the duration of operation and the amount of bleeding. We recommend restrictive cases.

80 View
0 Download

Treatment of Nonunion in the Long Bone with Low Intensity Pulsed Ultrasound (LIPUS) and LASER: In Ho Jeon, Chang Wug Oh, Sung Jung Kim, Hee Soo Kyung, Il Hyung Park, Byung Chul Park, Joo Chul Ihn, Jun Young Yeo; J Korean Soc Fract 2003;16(2):177-185. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.177

Abstract PDF: PURPOSE
Low-intensity, pulsed ultrasound (LIPUS) has demonstrated a stimulation and acceleration of the normal fracture-repair process in cellular bases as well in animal and human models. In this study, the adjunctive effect of LIPUS and LASER was investigated in established nonunion of the long bones.
MATERIALS AND METHODS
Study group consisted of eight patients to whom conventional bone graft and adjunctive LIPUS and LASER was applied. On the other hand, eight patients in the control group underwent bone graft only. Eleven men and five women were included in this study and the average age of the patients was 41.7 years (range, 19~62 years). Six of the tibias and ten of the femurs met the criteria for established nonunion. The average fracture age, the post-fracture period before the start of LIPUS/LASER treatment, was 502 days.
RESULTS
Seven of the ten nonunions who were treated by LIPUS and LASER healed completely in an average treatment time of 141 days (range, 101~202 days) and otherwise, in control group, five of the eight nonunions healed completely, in 240 days (range, 183~283 days).
CONCLUSION
This clinical study showed a positive effect of LIPUS and LASER on the rate of osseous repair, especially accelerated time to initial callus cortical bridging compared to that of conventional treatment.

77 View
0 Download

Management of Both Tibia Fracture: Kyung Jin Song, Sang Hun Song, Jong Hyuk Park; J Korean Soc Fract 2003;16(2):186-193. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.186

Abstract PDF: PURPOSE
The purpose of this study was to analyze the associated injury, difficulties in management and complications with surgery, and to suggest the guideline according to the severity and type of injury in the management of both tibia fractures. MATERIAL AND METHOD: We analyzed 12 patients, 8 men and 4 women and their age was 43.4 years old in average. The cause of injury was traffic accident in 10, autobike in 1 and farm machine injury in 1 case. There were both open tibia fracture in 6, one side open fracture in 2 and both closed fracture in 4 cases. We analyzed the average interval from injury to operation, duration of hospitalization, duration of both side bone union and complications.
RESULTS
In both open tibia fracture, the average interval from injury to operation was 12.5 days, average duration of hospitalization was 3.2 months, and average duration of bone union was 14.5 months. In one side open fracture, the average interval to operation was 25 days, average duration of hospitalization was 3.75 months, and average duration of bone union was 8.7 months. In both closed fracture, the average interval to operation was 15 days, average duration of hospitalization was 1.92 months, and average duration of bone union was 4.8 months.
CONCLUSION
Both tibia fractures were caused by high energy and also associated with multiple injury, and fracture stability and soft tissue damage should be evaluated thoroughly before surgery. Anatomical reduction and rigid fixation should be necessary to reduce the post-surgical complications.

42 View
0 Download

The Results of Operative Treatment in Open Type III Tibia Fracture: Kyung Jin Song, Sung Jin Shin, Byung Yun Hwang, Myung Sik Park; J Korean Soc Fract 2003;16(2):194-200. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.194

Abstract PDF: PURPOSE
The purpose of this study was to analyze the functional outcome and propose the guidelines in the surgical treatment of open type III tibial fracture.
MATERIALS AND METHODS
We have analyzed the treatment results of 44cases; age was ranged from 15 to 76 years, and there were 35 males and 7 females. The type of fracture according to the classification by Gustilo revealed type IIIa 14 cases, type IIIb 20 cases and type IIIc in 8 cases. We analyzed functional outcome according to the classification of functional result by Tucker.
RESULTS
The average union time of type IIIa was 9.2 months, IIIb 11.0 months, and IIIc was 13.8 months. The rotational flap and free flap were done during treatment and bone lengthening especially in type IIIc. Functional results were poor especially in type IIIc.
CONCLUSION
Debridement of devitalized tissue, early soft tissue coverage and sufficient stability using intramedullary nails will be necessary in type IIIa fracture. Rigid external fixation, early soft tissue coverage by rotational muscle flap and free flap reduced infection rate with satisfactory functional outcome especially in type IIIb and IIIc fractures.

42 View
0 Download

Intramedullary Nailing in Distal Tibial Meta-Diaphyseal Fracture: Kee Cheol Park, Young A Cho, Young Ho Kim, Tae Soo Park, Ye Soo Park, Il Hoon Sung, Kuhn Sung Whang; J Korean Soc Fract 2003;16(2):201-207. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.201

Abstract PDF: PURPOSE
This study was undertaken in order to evaluate the efficiency of the closed intramedullary nailing in 18 cases of distal tibial fractures.
MATERIALS AND METHODS
From May 1999 to June 2001, eighteen patients were treated by closed intramedullary nailing for distal tibial meta-diaphyseal fracture. According to Robinson classification, there were 7 type 1 fractures, 7 type 2A fractures, 1 type 2B fractures, and 2C type fractures. The mean distance between distal end of fracture and tibial plafond was 2.6+/-1.1 cm (0~5 cm). We evaluated both clinical and radiographic parameters.
RESULTS
Plate fixation of distal fibular fracture was performed in 7 cases. Poller screw was used in 4 cases which showed malalignment after insertion of nail. The mean score was 92.5 point by Blaird ankle scoring system. All patients got the bone union at average of 20 weeks (12~40 weeks). One patient had a antecurvatum deformity of 9 degrees.
CONCLUSION
Intramedullary nailing for distal tibial fractures is one of the safe and reliable method for managing these injuries.

86 View
0 Download

Radiological Assessment for Distal Fibular Length: Il Hoon Sung, Jong Min Lee; J Korean Soc Fract 2003;16(2):208-214. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.208

Abstract PDF: PURPOSE
This study was performed to reevaluate the radiological parameters for assessing the length of the distal fibula in the mortise view of the ankle and to introduce a more reliable method to lessen measurement error.
MATERIALS AND METHODS
Mortise view radiographs of 36 normal ankles from 18 healthy volunteers were obtained. The talocrural angle and bimalleolar angle were measured two times and compared bilaterally by two independent observers. Also, The lateral malleolar angle, newly devised in our department was measured and compared bilaterally.
RESULTS
The average of the talocrural angle, bimalleolar angle, and lateral malleolar angle was 78.4 degrees (range 74 to 83), 78.3 degrees (range 73 to 86), and 36.7 degrees (range 30 to 41), respectively. The difference of the talocrural angle, bimalleolar angle, and lateral malleolar angle between right and left was 2.1 degrees, 3.0 degrees, and 1.2 degrees (95% confidence limit), respectively. Intraobsever difference of the talocrural angle, bimalleolar angle, and lateral malleolar angle was 1.5 degrees, 1.6 degrees, and 0.4 degrees, respectively. Interobsever difference of the talocrural angle, bimalleolar angle, and lateral malleolar angle was 1.3 degrees, 2.4 degrees, and 1.0 degrees, respectively.
CONCLUSION
When using various measurement methods to judge the length of the distal fibula, the measurement error should be considered. The proposed method, lateral malleolar angle, would be a good method for assessing the length of distal fibula in the mortise view of ankle.

82 View
1 Download

Treatment of Distal Clavicle Type II Fracture using K-Wires and Tension Band Wiring: Whan Yong Chung, Woo Suk Lee, Taek Soo Jeon, Dae Hwan Kim, Kwang Kyoon Kim, Jae Woo Lim; J Korean Soc Fract 2003;16(2):215-221. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.215

Abstract PDF

PURPOSE
This is a retrospective study to analyze the clinical results of the usefulness of K-wires and tension band wiring that fix the fracture fragment directly without passing the acromioclavicular joint in distal clacivle type II fractures.
MATERIALS AND METHODS
From May 2000 to May 2001, eleven patients with distal clavicle type II fracture were treated by open reduction and internal fixation with K-wires and tension band wiring. The clinical results were analyzed according to modified shoulder rating scale for distal clavicle freacture. Radiological union, complication, and range of motion of the shoulder were assessed.
RESULTS
All fractures were united at 10 weeks (8~12 weeks) in average. Finally, full range of motion of the shoulder joint was achieved in all patients. No complication was found and the modified shoulder rating scale for distal clavicle fracture were as follows: excellent 9 and good 2.
CONCLUSION
K-wires and tension band wiring can be a good treatment method for distal clavicle type II fractures.

Citations

Citations to this article as recorded by

Tension Band Wiring for Distal Clavicle Fracture: Radiologic Analysis and Clinical Outcome
Seong Cheol Moon, Chul Hee Lee, Jong Hoon Baek, Nam Su Cho, Yong Girl Rhee
Journal of the Korean Fracture Society.2014; 27(2): 127. CrossRef

104 View
0 Download
1 Crossref

The Operative Treatment of Nonunions of Midshaft Clavicular Fractures: Reconstruction Plate Fixation and Bone Grafting: Young Soo Byun, Chan Hoon Yoo, Hyug Su An, Seong Gun Moon, Dong Ju Shin, Jun Woo Park; J Korean Soc Fract 2003;16(2):222-229. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.222

Abstract PDF: PURPOSE
The purpose of this study is to present our experience with open reduction, 3.5-mm reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fractures.
MATERIALS AND METHODS
Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-mm reconstruction plate, and bone-grafting. Postoperative mobilization started within one week.
RESULTS
The average duration of follow-up was 22.0 months. All fractures were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 out of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant.
CONCLUSION
The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.

85 View
0 Download

Delayed Brachial Plexus Palsy due to Clavicular Fracture: A Case Report: Woo Suk Lee, Whan Yong Chung, Taek Soo Jeon, Yong Sang Kim, Nam Hyun Kim; J Korean Soc Fract 2003;16(2):230-234. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.230

Abstract PDF

The brachial plexus palsies secondary to nonunion of the clavicle fracture are extremely rare. The nonunions are hypertrophic and usually in the middle third of the clavicle. Hypertrophic callus produced during healing process will cause a compression of the neurovascular bundle. This lesion requires operative treatment for decompression of the brachial plexus and internal fixation of nonunion. We present a case of delayed brachial plexus palsy due to nonunion and excessive callus formation of a clavicular fracture.

Citations

Citations to this article as recorded by

Progressive Brachial Plexus Palsy after Fixation of Clavicle Shaft Nonunion: A Case Report
Hong-Ki Jin, Ki Bong Park, Hyung Lae Cho, Jung-Il Kang, Wan Seok Lee
Journal of the Korean Fracture Society.2019; 32(2): 97. CrossRef

69 View
0 Download
1 Crossref

The Results of Surgical Treatment of Acute Acromio-clavicular Separation, Type III: Sung Ho Hahn, Bo Kyu Yang, Seung Rim Yi, Shun Wook Chung, Dong Ho Lee, Min Seok Kim; J Korean Soc Fract 2003;16(2):235-243. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.235

Abstract PDF: PURPOSE
The purpose of this study is to compare the Phemister technique with the modified Phemister technique for the patients with Rockwood type 3, acromio-clavicular separation.
MATERIALS AND METHODS
The 45 cases of 45 patients received surgical treatment for Rockwood type 3, acute acromio-clavicular separation in our hospital from Feb. 1992 to Aug. 2001 later with the follow-up study were selected as subjects. The average ages were 28.1 years old, male and female were 42, 3 persons, respectively. Physical examination and plain radiography were used for their diagnosis and the intervals between injury and surgical treatment were 7.8 days. In intraoperative finding, we performed Phemister technique in 15 cases according not to be able to repair coraco-clavicular ligament (group I), modified Phemister technique in 30 cases according to be able to repair that (group II). The average follow up period was 16.2 months, and the UCLA shoulder scoring system and the acromio-clavicular separation scoring system were used to obtain clinical results.
RESULTS
Only in Group II, the complication after surgery were associated with superficial infection in two cases and K-wire migration in one case. At last follow up, there were no pain and limitation of range of motion in all cases, and two cases in Group II were found to be subluxation in radiography. Clinical results revealed excellent was 93.3%, good was 6.7% in UCLA shoulder scoring system in both groups, and excellent was 90%, good was 10% for group II in acromio-clavicular separation scoring system.
CONCLUSION
The results are considered to be good with only Phemister technique in type 3, acute injury occurred in working ages.

59 View
0 Download

Anterior Approach and Volar T-plate fixation of Distal Radius Fracture: Woo Sung Choi, Weon Yoo Kim, Dong Won Choi, Yun Hack Shin, Jin Young Kim; J Korean Soc Fract 2003;16(2):244-252. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.244

Abstract PDF

PURPOSE
To analyze the radiologic and clinical results of open reduction and volar plating through anterior approach for distal radius fracture.
MATERIALS AND METHODS
We retrospectively analysed that 19 distal radius fracture, which would not be reduced by closed reduction or too comminuted to maintain reduction or articular surface incongruency, were treated by open reduction and volar plating through anterior approach. The results were evaluated by preoperative and immediate postoperative radiographics and clinical results were analysed using Green and O'Brien scoring system at final follow up.
RESULTS
All cases achieved anatomical articular surface reduction postoperatively. In terms of radiologic analysis, mean radial length (8.8 mm +/-4.8 mm vs. 11 mm +/-3 mm), radial inclination (15 degrees+/-5.7 degreesvs. 20degrees+/-5degrees), volar tilt (-11 degrees+/-13 degrees vs. 7 degrees+/-4 degrees) and ulnar plus variant (4 mm+/-3 mm vs. 0 mm+/-1 mm) were improved. The clinical evaluation revealed 9 excellent cases, 7 good cases, 2 fair cases and 1 poor case. The reduction loss and flexor pollicis longus rupture was occurred in one patient, who had severely displaced comminute fracture in initial injury.
CONCLUSION
Using volar plating, authors gain good radiologic and clinical results. But, additional external fixation is recommended to prevent further collapse in severly comminuted fractures.

Citations

Citations to this article as recorded by

Treatment of Fractures of the Distal Radius Using Variable-Angle Volar Locking Plate
Jae-Cheon Sim, Sung-Sik Ha, Ki-Do Hong, Tae-Ho Kim, Min-Chul Sung
Journal of the Korean Fracture Society.2015; 28(1): 46. CrossRef

63 View
0 Download
1 Crossref

Treatment of Post-traumatic Dislocation of Metacarpophalangeal Joints of the Hand: Seung Koo Rhee, Seok Whan Song, Joo Yup Lee, Chang Youn Moon, Jae Chan Oh; J Korean Soc Fract 2003;16(2):253-261. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.253

Abstract PDF: PURPOSE
To analyse the obstacles to prevent the reduction for dislocation of the metacarpophalangeal (MP) joints of the hand and evaluate the relationship between the sex and dislocation type in closed reduction case.
MATERIALS AND METHODS
Total 27 cases of MP joint dislocation of the hand (11 cases of thumb, and 14 index and 2 little finger) were reviewed retrospectively. The anatomical structures to prevent the reduction were confirmed at operation and the cases which were reduced immediately were also analysed for their ages and differences of damaged structures, and finally their complications or outcome were reviewed for average 7 months after reduction.
RESULTS
In 11 cases of thumb MP joint dislocations, the complex dorsal dislocations in which the protruded metacarpal neck was caught by buttonhole of torn anterior joint capsule, volar plate and FPB were reduced by open method in 8 cases, and closed reduction was done in 2 cases but one old case required arthrodesis. In other finger MP joint dislocations, the Kaplan's concept to prevent the reduction was confirmed. But reduction of torn volar plate and incision of transverse metacarpal ligament were sufficient to reduce the dislocation with gentle longitudinal traction during the operation. In two cases of little finger MP joint dislocation, the ruptured radial collateral ligaments were noted after open reduction and it must the repaired to prevent the finger instability later. Their overall end results were good without any significant restriction of MP joints motions and finger instabilities.
CONCLUSION
One or two times of closed reduction with proper local anesthesia could be tried, but simple reducible dislocation can be converted to complex irreducible ones by the inappropriate traction method, and so proper reduction technique by closed or even in open way is important with the knowledge of anatomical obstacles to prevent the reduction of the metacarpophalangeal joints.

45 View
0 Download

Fracture of Vertebral Body in Flexion-Distraction Injury of Thoracolumbar Spine: Young Do Koh, Jong Oh Kim, Yeo Hon Yun, Jae Doo Yoo, Jun Mo Jung; J Korean Soc Fract 2003;16(2):262-269. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.262

Abstract PDF

PURPOSE
To evaluate the configuration of vertebral body fractures in flexion-distraction injuries of thoracolumbar spine.
MATERIALS AND METHODS
We investigated the location of fractures, anterior or posterior vertebral body height, kyphotic angle of injured segments, canal encroachment and severity of comminution on radiologic examinations of 21 cases.
RESULTS
There were 11 compression fractures and 9 burst fractures. 85% of fractures were located in the inferior vertebrae of injured segments. Anterior vertebral height decreased by 27% on average with decrease of 18% in compression fractures and 40% in burst fractures. Posterior height decreased by 1% on average with increase of 1% in compression fractures and decrease of 4% in burst fractures. The average kyphotic angle of injured segments was 19.5 degrees with 15.4degrees in compression fractures and 26.8 degrees in burst fractures. The canal encroachment in 9 burst fractures was 27% on average, and the comminution of vertebral body was mild in 74%.
CONCLUSION
The fracture of vertebral body in flexion-distraction injuries of thoracolumbar spine was very common, and located on the inferior vertebrae of injured segment. The decrease of vertebral height, canal encroachment and severity of comminution was relatively less than the estimated from mechanism of injury, with offset effect of distraction force.

Citations

Citations to this article as recorded by

Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
Journal of Korean Society of Spine Surgery.2012; 19(2): 47. CrossRef

84 View
0 Download
1 Crossref

Treatment of the Children's Femur Shaft Fracture by Early Spica Cast: Kwang Hoon Chung, Jong Sup Shim, Ki Sun Sung, Seung Jun Park; J Korean Soc Fract 2003;16(2):270-277. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.270

Abstract PDF

PURPOSE
To investigate the proper indication, technical point and complication of the early hip spica cast.
MATERIALS AND METHODS
Thirty-one children with thirty-two fractures more than 2-year follow up were included. The patient's average age and weight were 5 year 2 months and 19.1 Kg respectively. Spica cast was applied as follow. First short leg cast was applied, and then patient was placed on the spica cast table. During the cast incorporation, the hip and knee flexed sufficiently to maintain length and alignment of the fracture, and popliteal fossa was well molded and padded. The meticulous valgus molding of the fracture site was also needed.
RESULTS
Average bayonet overriding of the fracture was initially 1.1 cm, however it increased to 1.5 cm during cast immobilization. In the 9 patients (28.1%), cast wedging correction were needed to 3 to 14 days after initial cast immobilization and the cause of correction was related to patients weight. At the final follow up, there was no serious functional or cosmetic complications.
CONCLUSION
For the successful treatment, the proper patients selection, meticulous cast application and careful radiographic assessment after cast application were needed.

Citations

Citations to this article as recorded by

Stiff Knee by Entrapment of Quadriceps Femoris Tendon at Fracture Site in Paediatric Distal Femur Shaft Fracture
Suk Kang, Jong Pil Kim, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Sang Ho Lee, Jin Wook Chung
Journal of the Korean Fracture Society.2007; 20(4): 339. CrossRef

106 View
0 Download
1 Crossref

The Correlation between Surgical Timing and Perioperative Complications in the Treatment of Displaced Supracondylar Humeral Fractures of Children: Soo Hong Han, Duck Yun Cho, Hyung Ku Yoon, Byung Soon Kim, Jae Hwa Kim, Hyung Kun Park, Se Hyen Kim; J Korean Soc Fract 2003;16(2):278-283. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.278

Abstract PDF: PURPOSE
Even though emergent percutaneous pinning after closed reduction is the popularized treatment of the displaced type II and type III pediatric supracondylar fractures of the humerus, the timing of pinning still presents controversy. The purpose of this study is to suggest an appropriate surgical time without significant perioperative complications.
MATERIALS AND METHODS
From April 1995 to January 2002, 179 consecutive patients who had undergone surgical treatment were selected. They were divided to 5 groups [A group: 8 hours or less following injury (24 cases), B group: from 9 to 16 hours (63 cases), C group: from17 hours to 24 hours (63 cases), D group: from 25 hours to 48 hours (18 cases), and E group: from 49 hours to 72 hours (11 cases)] and reviewed retrospectively to analyze perioperative complications and operation time.
RESULTS
There was no significant difference between each group with respect to surgical wound infection, iatrogenic ulnar nerve injury, VIC, operation time and the necessity of reoperation (p>0.05).
CONCLUSION
Within the parameters outlined in our study, we could not find the any meaningful correlation between surgical timing and occurrence of perioperative complications and also, we think that the timing of percutaneous pinning can be delayed to the time when a surgeon considers it appropriate.

94 View
0 Download

The Analysis of the Percutaneuos Pinning of Supracondylar Fractures in Children: SangMok Lee, SoHak Jung, JaeHo Jang, JungHwan Son, JaeDo Kim; J Korean Soc Fract 2003;16(2):284-291. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.284

Abstract PDF: PURPOSE
Supracondylar fracture was known as supracondylar dilema because of complication and difficulty in treatment. Many methods were devised to prevent and minimize the complications. Among the treatment methods, closed reduction and percutaneous pinning was widely used for most of supracondylar fractures. But arguments was existed for the the pinning methods such as pinning site and number of pins.
MATERIALS AND METHODS
We reviewed 44 cases of displaced supracondylar fractures treated by closed reduction and percutaneous pining. The pins were removed about 4~5 weeks after operation and range of motion was begun. All cases was reviewed restropectively and results was analysed by Flynn grading system. The pinning method was analysed.
RESULTS
There were no significant clinical results among the methods of percutaneous pinnings. Even though two crossed pins from the lateral and medial condyles were preferable for most fractures. The results are that 1)At least 2 K-wires were needed. 2)Prognosis was not influenced by the pinning site. 3)The complication was prevented by accurate reduction using image intensifier during operation.
CONCLUSION
Two lateral parallel pins were alternative method for marked swelling and severely displaced fractures.

88 View
0 Download

Birth Injury: Tai Seung Kim, Khun Sung Whang, Joo Hak Kim; J Korean Soc Fract 2003;16(2):292-298. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.292

Abstract PDF: PURPOSE
Birth injury is any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those from hypoxia and mechanical factors. Risk factor of birth injuries have been reported to breech presentation, forcep delivery, cephalopelvic disproportion, dystocia, and high birth weight. But, because of preterm care and development of delivery method and Cesarian section, recently the rate of birth injury was decreasing and the articles about birth injuries in orthopaedic fields have not been much. We analyzed the data about birth injuries occurred during recent 11 years.
MATERIALS AND METHODS
We reviewed the charts and patients the 17 patients (20 cases) of birth injuries including fracture, nerve injury during the delivery at Hanyang University hospital from Jan. 1991 to Dec. 2001. But, we excluded birth injury of head and abdomen.
RESULTS
The number of fracture and nerve injuries on extrimities in our hospital were clavicle fracture 9 cases, brachial plexus injury 6 cases, femur fracture 3 cases, separation of distal femoral epiphysis 1 case, humerus fracture 1 case. Patients of clavicle fracture were born at mean intrauterine period 41.5 weeks and mean birth weight of the patients was 4.25 kg. Patients of brachial plexus injury were born at mean intrauterine period 39.5 weeks and mean birth weight of the patients was 4.42 kg. Three cases of femoral fracture were all due to breech position while cesarean operartion and one of these cases were born as ishiophagus. We found the distal femoral epiphyseal separation injury missed initially and diagnosed a kind of birth injuries through remarkable periosteal reaction.
CONCLUSION
The birth injuries including clavicle fracture and brachial plexus injury are highly related to high birth weight at birth and the femur fractures are related to delivery maneuver in C-section and breech delivery. Strict observation and monitoring are required because occasionally the paralysis might be the sign of brachial plexus injury or pseudoparalysis due to fracture. By the adequate preterm care or preterm ultrasound check up, high weight delivery could be avoided and then the birth injury must be reduced.

41 View
0 Download

Distal Clavicle Fracture in Adolescence Mimicking Type IV Acromioclavicular Joint Injury: Tae Woo Park, Sung Do Cho, Chae Chil Lee; J Korean Soc Fract 2003;16(2):299-303. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.299

Abstract PDF: Distal clavicle fracture in children may mimic acromioclavicular joint separation, but have very different prognosis and treatment. We are reporting two cases of distal clavicle fracture in adolescence mimicking type IV acromioclavicular injury. This report demonstrates the importance of shoulder axillary view, computerized tomography as well as physical examination on diagnosis of the distal clavicle fracture in adolescence.

84 View
0 Download

Fracture of the Medial Epicondylar Apophysis of Distal Humerus with Subluxation of the Radial Head: A Case Report: Han Yong Lee, Kee Won Rhyu, Jin Young Jeong, Joo Hyoun Song, Hae Seok Koh, Yong Koo Kang, Mun Ik Sohn; J Korean Soc Fract 2003;16(2):304-307. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.304

Abstract PDF: It has been known that fracture of medial epicondylar apophysis of distal humerus may be isolated or associated with elbow dislocations. We have experienced a case which medial epicondylar fracture of the distal humerus was associated with subluxation of the radial head. Initially, we had tried reduction of subluxated radial head by closed method, but failed. Finally open reduction had been performed. At 6 month after open reduction, clinical and radiological result were excellent. As it is difficult for those associated injuries to occur simultaneously and the similar cases never have been reported yet, we would like to present this case with a review of the literature.

51 View
0 Download

Previous issues